It was like the end of the arms race last November when Pfizer announced it was slashing its national sales force by 20 percent. Coolly downplayed as cost-cutting by new CEO Jeffrey Kindler, the stunning move was met by industry insiders, Wall Street analysts, and the media with one humongous collective sigh of relief. Big Pharma was seen as having grown dangerously addicted to the detailing game over the past decade, with the top firms plowing more and more of their blockbuster profits into trying to keep up with Pfizer's "flood the zone" strategy and with less and less to show for it.

With more hospitals, medical groups, and even individual doctors instituting closed-door policies, the model of mirrored sales forces armed with 20-second details battering doctor's offices had become a bad joke. It was no secret that reps needed to regain value with their customers. The return on investment of these mass-market product pushes, always hard to quantify, was looking increasingly hard to justify.

In the immediate aftermath of Kindler's announcement, there was a sense of great expectations: Which drug giant would be next to de-escalate? How far would Big Pharma go in this first round of layoffs? How soon would the new lean-and-sober model be ready to roll? And what would it look like? Pharm Exec phoned the field's best and brightest experts, only to discover that six months later everyone is still waiting for the other shoe to drop.

"You don't see the kind of dramatic change that you'd think would be coming," says Jack Nightingale, a consultant for Numerof & Associates. "Changing the model is a high-risk thing to do in the short-term because, frankly, it's still successful. There are a number of blockbuster products out there continuing to gain or hold market share based in part on having a lot of feet on the street."

Frank Ciriello

No company has announced major layoffs since Pfizer's cut. "Companies are now just reducing their sales forces by not filling their vacancies," says Mason Tenaglia, managing director of the Amundsen Group. Instead, companies are test-driving some pilot programs. However, sales experiments thus far have constituted modest variations on tried-and-true themes. They show an evolution—instead of a revolution—when it comes to professional marketing. Particularly surprising to many observers is the lack of innovation in the managed-markets sector.

Indeed, rather than any deliberate, strategic reform, the current sales-model scene reveals that most of the action is just a reaction to the drugs coming down the pipeline. "You play the hand your dealt," says Stephen Gerard, managing partner for TGaS Advisors. "Sales models are driven by the drugs that are coming—everything else is just spin."

Big Pharma companies with expanding portfolios, like Novartis and Roche, are mostly taking a watch-and-wait approach and collecting information on reps' value and productivity in doctors' offices, according to Garry O'Grady, senior vice president, sales practice, Campbell Alliance. Companies with stable portfolios, like GlaxoSmithKline and Abbott Labs, are going a step further, tweaking their field forces to increase productivity—often by borrowing from the playbook of midsize firms, which have traditionally been more cautious and strategic in deploying sales forces in the overall promotional mix.

Hans Bishop

However, only the companies with the declining portfolios, like Pfizer and Merck, "are seeking profound change and have the greatest willingness to pilot and experiment new approaches to the marketplace," says O'Grady. "And it is in this group where the action is, in terms of sales-model variation."